Ann L Clark, MD

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

28017 Issued in KY

Practice address

2211 Mayfair Dr
Suite 305
Owensboro, KY 42301-4568

Phone

(270) 688-2018

Fax

(270) 688-2029

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Owensboro Health Medical Group Inc

  • Surgery Physician
  • Greenville, KY
  • NPI 1235518242
  Medicare reassignment NPD
• Owensboro Health Medical Group Inc

  • Internal Medicine Physician
  • Owensboro, KY
  • NPI 1306700711
  NPD
• Owensboro Health Medical Group, Inc

  • Otolaryngology Physician
  • Owensboro, KY
  • NPI 1558779009
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1487748968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 MAYFAIR DR",
            "address_2": "SUITE 305",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423014568",
            "telephone_number": "270-688-2018",
            "fax_number": "270-688-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "KY",
            "license": "28017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- NMFM SPEC.",
            "identifier": "K030861",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200036070",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM- NMFM SPEC.",
            "identifier": "000000759531",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64036437",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CK Lewis Enterprises Inc
• Clark Chiropractic Center, LLC
• Clark Chiropractic Center,LLC
• Sandra Rene Clark Howard, DMD
• Aaron P. Clark, D.C.
• Benjamin Paul Clark, PHARM.D, MPA
• Emily Kaye Clark, APRN
• Ian Clark, PA
• Jazmyne Clark
• Jill Clark, PHARMD.

• Maternal & Fetal Medicine Physician in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Maternal & Fetal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.